Your Members Deserve the Best Health Plan
Proven, Configurable Solutions
Health plans need a secure, efficient, and trusted source for provider data that mitigates risk, lowers operational costs, and streamlines network administration functions so you can focus on delivering quality care and achieving optimal outcomes. Failure in either area creates the potential for significant fines for non-compliance, litigation risk, payment/billing issues and reputational damage.
Verisys is an industry leader in provider credentialing, leveraging data-rich tools and longitudinal provider profiles to streamline processes, accelerate verifications, and enable compliant, aligned provider networks for hundreds of healthcare payors and related stakeholders across all sides of the industry. Clients include national and regional health plans, dental and vision plans, and State Medicaid agencies.
Streamline network administration with our configurable payer credentialing solutions and up-to-the-minute provider directories powered by accurate, verified data.
Payer Solutions
Provider Credentialing
Verisys is the largest outsourced credentialing provider in the market today and the only player with the workflow expertise and in-house database (i.e., FACIS) to efficiently serve the end-to-end needs of large healthcare clients. For three decades, Verisys has supported client components of network management to ensure regulatory compliance and enable payors to keep an up-to-date provider network. Verisys credentialing is the only NCQA and URAC accredited solution to maintain the industry’s highest data and compliance standards. We can help you do anything from a simple provider credential search to implementing a full end-to-end credentialing solution.
Provider Data & Roster Management
Verisys’ provider directory management solutions transform often-flawed provider data into comprehensive, customizable directories that integrate seamlessly with your member portal. We display intricate networks how you want your members to see them, highlighting and tiering network providers just for them — including telemedicine providers.
By offering a more comprehensive, integrated provider search platform, you can keep current members satisfied and engaged while attracting new customers who want to strengthen member engagement. Moreover, by delivering relevant, actionable information, consumers can make informed decisions leading to better outcomes—one of healthcare reform’s primary goals.
FACIS (Comprehensive Exclusions)
FACIS® is a database of 10 million records from 5,000 primary sources on provider exclusions, sanctions, and adverse events. FACIS delivers 360-degree transparency on providers, staff, and entities for the organizations who hire, credential, refer, and reimburse for healthcare delivery. When it comes to keeping customers and patients safe, you need the gold standard.
License & Other Data Verification
Provide a point-in-time verification of a professional license number, including status, issue and expiration date, primary source information, and any disciplinary action (current or historical). Searches aliases provided on each practitioner as part of the search criteria and verification process